California Supreme Court to rule on insulin shots to diabetic students

The Sacramento BeeAugust 11, 2013 

The California Supreme Court is expected to rule today whether non-nursing staff and faculty can give insulin shots to diabetic students.

JAMES ESTRIN — NYT

The California Supreme Court is poised to rule today on one of the most emotional issues currently before it: whether school employees should be able to give insulin shots to diabetic students if a nurse is not available.

The case pits parents who want voluntarily trained, non-nursing staff and faculty to give the shots to their children against a nurses' union claiming inappropriately administered shots could lead to harm and even tragedy.

The parents are backed by the American Diabetes Association, which brought the case to the high court after two lower courts in Sacramento ruled state law mandates only licensed professionals may administer the shots.

Notably, the Obama administration filed a brief with the Supreme Court in support of the parents.

If the law is flawed, it must be changed by the Legislature, a unanimous three-justice panel of the 3rd District Court of Appeal concluded in June 2010. In an illustration of the strong feelings present in the debate, Arthur G. Scotland, now-retired presiding justice of the 3rd District, posed the question in a biting concurrence whether the law is "the product of a legitimate concern for the safety of diabetic school children or the result of a labor organization protecting its turf and flexing its political muscle."

Tani Cantil-Sakauye, then an associate justice of the 3rd District, authored the Sacramento appellate court's opinion. In addition to Scotland, she was joined by now-retired Associate Justice Rick Sims. Subsequently, then-Gov. Arnold Schwarzenegger appointed her chief justice of the Supreme Court. She is recused from the matter at that level, and William R. McGuiness, presiding justice of the San Francisco 1st District Court of Appeal, has replaced her.

While the case has been on appeal from Sacramento Superior Court to the district court and then on to the state Supreme Court, enforcement of the law has been stayed and, in accord with a 2007 state Department of Education rule, trained school personnel have been able to give the shots in the absence of a nurse.

If the discussion at the May oral arguments before the Supreme Court is any indication, the court might well vote to strike down the law requiring licensed professionals.

Justice Joyce L. Kennard noted that parents routinely administer the shots in non-school settings, and children who are old enough give themselves the injections.

"If my child has a life-threatening insulin problem, either do I hope that (the child) can inject himself ... or do I rush home from work — is that how it works?" asked Justice Carol A. Corrigan.

Asked by Justice Ming W. Chin if she would be satisfied if a school employee was given all necessary information about the specific needs of a child, American Nurses Association lawyer Maureen Cones replied, "No. The law says what it says."

The case "at its heart is about protecting students," Cones added.

But many parents insist the law is unworkable because of the state's critical shortage of school nurses from a lack of funding.

Diabetes association attorney Dennis Maio told the high court that 26% of schools in California have no nurses.

"Something's got to give," Maio declared, especially since a child's need for insulin can be "unpredictable."

When Cones argued that it is up to the state to fund more nurses, Chin asked: "But in the meantime, what about the kids?"

 

The reporter can be reached at dwalsh@sacbee.com or (916) 321-1089.

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